ABSTRACT
Background: Brachial plexus injuries are difficult to manage situation for surgeons
Objective: To assess the effects of saha's procedure on improving the range of movement of shoulder joint with brachial plexus injury
Methodology: We conducted a quasi-experimental study of twelve patients with absent or extremely weak shoulder abduction [motor grade 2 or less] due to traumatic brachial plexus injuries [C5-C6-C7/C5-C6 deficit], who had undergone surgical reconstruction of the flail shoulder by tendon transfer [Steindler elbow flexorplasty]. The etiology of shoulder weakness in all patients was traumatic brachial plexus palsy [C5-C6-C7/C5-C6 deficit] from 1[st] January 2011 to 31[st] December 2014. Shoulder abduction improved or not improved measured in term of range of motion at shoulder joint. Age, gender, preoperative strength [rated on a 0 to 5 scale for the trapezius], previous surgery, length of follow-up, other associated operative procedures, results and complications were recorded
Results: We operated on twelve patients and average age at which patients presented was 22.83 in which only one was female. The percentage years of C5-C6 and C5-C6-C7 were 86.66% and 13.33% respectively. Average time elapsed since injury was 23 months. We followed the patients on average of about 2 years. The Average increase [change] in the abduction range was 74.10
Conclusion: Saha's procedure is good and effective procedure in improving the range of motion [Change] at shoulder joint in traumatic brachial plexus injuries [C5-C6-C7/C5-C6 deficit]
ABSTRACT
Objective: To share our experience of post-circumferential Volkmann's Ischemic Contracture [VIC] of the forearm seen in our setup. Design: A descriptive case series study. Setting: National Orthopedic Hospital, Bahawalpur, Pakistan. Period: January 2005 to December 2013
Methodology: A total of 42 patients were registered during the study period. Patients with VIC of the forearm resulting from direct circumferential compression were included in the study. Patients who developed VIC of forearm indirectly secondary to arm pathology or other causes were excluded from the study. Assessment was made by detailed history, clinical examination and radiographs of the involved extremity. The age, sex, duration, side and type of contracture, length and width of forearm and resulting deformities were all documented on a detailed proforma. Patients were categorized into three types accordingly
Results: Forty two patients comprising 29 males and 13 females were seen. Their ages ranged from 1 to 53 years with mean age of 14.47 years. Duration of established VIC of the forearm after insult ranged from 3 months to 6 years with mean duration of 2 ½ years. Most frequent type of contracture was moderate variety seen in 19 patients [45.23%] with 14 cases on the right and 5 cases on left side followed by severe varieties which were present in 13 patients [31%] with 10 cases on the right and 3 cases on left side. Mild contractures were found in 10 patients [23.9%] with 6 cases on the right and 4 cases on left side. In 26 of 42 patients, a difference in forearm length that ranged from 79% to 94% [mean, 80%] was observed. Majority of cases [37 cases] of VIC occurred after TBS for radius and ulna fractures while in the remaining 5 cases, contractures of forearm occurred due to tight plaster of paris [POP] splint
Conclusions: Post-circumferential forearm contractures after Traditional Bone Setters [TBS] are common in our society. Community awareness through health education and conducting medical camps and seminars might play a role in decreasing the influence of TBS